The investigation and management of suspected malignant pathological fractures: A review for the general orthopaedic surgeon
Abstract The management of malignant pathological fractures necessitates careful diagnostic work-up, pre-operative investigation, planning and multidisciplinary input from specialists in the fields of radiology, pathology, oncology, trauma and orthopaedics. Malignant and non-malignant conditions inc...
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| Veröffentlicht in: | Injury 2015-10, Vol.46 (10), p.1891-1899 |
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| creator | Bryson, D.J Wicks, L Ashford, R.U |
| description | Abstract The management of malignant pathological fractures necessitates careful diagnostic work-up, pre-operative investigation, planning and multidisciplinary input from specialists in the fields of radiology, pathology, oncology, trauma and orthopaedics. Malignant and non-malignant conditions including metabolic disorders, benign tumours and pharmacological therapies can be implicated. The majority of patients who present with suspected pathological fractures will be managed by general orthopaedic and trauma surgeons rather than specialists in orthopaedic oncology. Skeletal metastases can result in considerable morbidity and predispose to pathological fractures. With advances in the medical management of malignancy, life expectancy in cancer patients is increasing, leading to an increasing risk of skeletal metastasis and the potential for pathological fractures. Conventional modes of trauma fixation for pathological fractures may not be appropriate. The aim of this review is to outline diagnostic and management strategies for patients who present with a long bone fracture that is potentially pathological in nature. |
| doi_str_mv | 10.1016/j.injury.2015.07.028 |
| format | Article |
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Malignant and non-malignant conditions including metabolic disorders, benign tumours and pharmacological therapies can be implicated. The majority of patients who present with suspected pathological fractures will be managed by general orthopaedic and trauma surgeons rather than specialists in orthopaedic oncology. Skeletal metastases can result in considerable morbidity and predispose to pathological fractures. With advances in the medical management of malignancy, life expectancy in cancer patients is increasing, leading to an increasing risk of skeletal metastasis and the potential for pathological fractures. Conventional modes of trauma fixation for pathological fractures may not be appropriate. The aim of this review is to outline diagnostic and management strategies for patients who present with a long bone fracture that is potentially pathological in nature.</description><identifier>ISSN: 0020-1383</identifier><identifier>EISSN: 1879-0267</identifier><identifier>DOI: 10.1016/j.injury.2015.07.028</identifier><identifier>PMID: 26254572</identifier><language>eng</language><publisher>Netherlands: Elsevier Ltd</publisher><subject>Blood Investigations ; Bone Cements ; Bone Neoplasms - diagnosis ; Bone Neoplasms - secondary ; Bone Neoplasms - surgery ; Cementation - methods ; Early Detection of Cancer ; Fracture Fixation, Internal - methods ; Fractures, Spontaneous - diagnostic imaging ; Fractures, Spontaneous - etiology ; Fractures, Spontaneous - surgery ; Humans ; Multiple Myeloma - complications ; Multiple Myeloma - diagnostic imaging ; Multiple Myeloma - surgery ; Orthopedics ; Pathological fracture ; Practice Guidelines as Topic ; Radiological Investigation ; Skeletal Metastases ; Surgeons ; Surgical management</subject><ispartof>Injury, 2015-10, Vol.46 (10), p.1891-1899</ispartof><rights>Elsevier Ltd</rights><rights>2015 Elsevier Ltd</rights><rights>Copyright © 2015 Elsevier Ltd. 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Malignant and non-malignant conditions including metabolic disorders, benign tumours and pharmacological therapies can be implicated. The majority of patients who present with suspected pathological fractures will be managed by general orthopaedic and trauma surgeons rather than specialists in orthopaedic oncology. Skeletal metastases can result in considerable morbidity and predispose to pathological fractures. With advances in the medical management of malignancy, life expectancy in cancer patients is increasing, leading to an increasing risk of skeletal metastasis and the potential for pathological fractures. Conventional modes of trauma fixation for pathological fractures may not be appropriate. The aim of this review is to outline diagnostic and management strategies for patients who present with a long bone fracture that is potentially pathological in nature.</description><subject>Blood Investigations</subject><subject>Bone Cements</subject><subject>Bone Neoplasms - diagnosis</subject><subject>Bone Neoplasms - secondary</subject><subject>Bone Neoplasms - surgery</subject><subject>Cementation - methods</subject><subject>Early Detection of Cancer</subject><subject>Fracture Fixation, Internal - methods</subject><subject>Fractures, Spontaneous - diagnostic imaging</subject><subject>Fractures, Spontaneous - etiology</subject><subject>Fractures, Spontaneous - surgery</subject><subject>Humans</subject><subject>Multiple Myeloma - complications</subject><subject>Multiple Myeloma - diagnostic imaging</subject><subject>Multiple Myeloma - surgery</subject><subject>Orthopedics</subject><subject>Pathological fracture</subject><subject>Practice Guidelines as Topic</subject><subject>Radiological Investigation</subject><subject>Skeletal Metastases</subject><subject>Surgeons</subject><subject>Surgical management</subject><issn>0020-1383</issn><issn>1879-0267</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkU-LFDEQxYMo7uzoNxDJ0Uu3lX_TGQ_CsqgrLHhwPYd0ptKbsScZk-6VAT-8aWb14MVTQfHeK-r3CHnFoGXANm_3bYj7OZ9aDky10LXA9ROyYrrbNsA33VOyAuDQMKHFBbksZQ_AOhDiObngG66k6viK_Lq7RxriA5YpDHYKKVIbd_Rgox3wgHGiydMylyO6CZf9GIZo6_pop_s0piE4O1KfrZvmjOUdvaIZHwL-pD5lOtXwASPmqkm5Go4Wd8HVwDxgii_IM2_Hgi8f55p8-_jh7vqmuf3y6fP11W3jFBNT06uuV4JL1Qu11RydZNqB8lo69EoKBYJ1HLS3QvTa695tpddKS9HtpFRerMmbc-4xpx9zfdUcQnE4jjZimothHdNb2ECFsybyLHU5lZLRm2MOB5tPhoFZuJu9OXM3C3cDnancq-3144W5P-Dur-kP6Cp4fxZg_bPyyaa4gNFVHLmiNbsU_nfh3wA3hrjQ_44nLPs051gZGmYKN2C-Lt0v1TMFICVI8RvGT6yD</recordid><startdate>20151001</startdate><enddate>20151001</enddate><creator>Bryson, D.J</creator><creator>Wicks, L</creator><creator>Ashford, R.U</creator><general>Elsevier Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20151001</creationdate><title>The investigation and management of suspected malignant pathological fractures: A review for the general orthopaedic surgeon</title><author>Bryson, D.J ; Wicks, L ; Ashford, R.U</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c513t-b57b53245b35982ec418c05f84cef54350317208fa33b8f8bc94f858437d445f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Blood Investigations</topic><topic>Bone Cements</topic><topic>Bone Neoplasms - diagnosis</topic><topic>Bone Neoplasms - secondary</topic><topic>Bone Neoplasms - surgery</topic><topic>Cementation - methods</topic><topic>Early Detection of Cancer</topic><topic>Fracture Fixation, Internal - methods</topic><topic>Fractures, Spontaneous - diagnostic imaging</topic><topic>Fractures, Spontaneous - etiology</topic><topic>Fractures, Spontaneous - surgery</topic><topic>Humans</topic><topic>Multiple Myeloma - complications</topic><topic>Multiple Myeloma - diagnostic imaging</topic><topic>Multiple Myeloma - surgery</topic><topic>Orthopedics</topic><topic>Pathological fracture</topic><topic>Practice Guidelines as Topic</topic><topic>Radiological Investigation</topic><topic>Skeletal Metastases</topic><topic>Surgeons</topic><topic>Surgical management</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Bryson, D.J</creatorcontrib><creatorcontrib>Wicks, L</creatorcontrib><creatorcontrib>Ashford, R.U</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Injury</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Bryson, D.J</au><au>Wicks, L</au><au>Ashford, R.U</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The investigation and management of suspected malignant pathological fractures: A review for the general orthopaedic surgeon</atitle><jtitle>Injury</jtitle><addtitle>Injury</addtitle><date>2015-10-01</date><risdate>2015</risdate><volume>46</volume><issue>10</issue><spage>1891</spage><epage>1899</epage><pages>1891-1899</pages><issn>0020-1383</issn><eissn>1879-0267</eissn><abstract>Abstract The management of malignant pathological fractures necessitates careful diagnostic work-up, pre-operative investigation, planning and multidisciplinary input from specialists in the fields of radiology, pathology, oncology, trauma and orthopaedics. Malignant and non-malignant conditions including metabolic disorders, benign tumours and pharmacological therapies can be implicated. The majority of patients who present with suspected pathological fractures will be managed by general orthopaedic and trauma surgeons rather than specialists in orthopaedic oncology. Skeletal metastases can result in considerable morbidity and predispose to pathological fractures. With advances in the medical management of malignancy, life expectancy in cancer patients is increasing, leading to an increasing risk of skeletal metastasis and the potential for pathological fractures. Conventional modes of trauma fixation for pathological fractures may not be appropriate. 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| fulltext | fulltext |
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| ispartof | Injury, 2015-10, Vol.46 (10), p.1891-1899 |
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| source | MEDLINE; Elsevier ScienceDirect Journals Complete |
| subjects | Blood Investigations Bone Cements Bone Neoplasms - diagnosis Bone Neoplasms - secondary Bone Neoplasms - surgery Cementation - methods Early Detection of Cancer Fracture Fixation, Internal - methods Fractures, Spontaneous - diagnostic imaging Fractures, Spontaneous - etiology Fractures, Spontaneous - surgery Humans Multiple Myeloma - complications Multiple Myeloma - diagnostic imaging Multiple Myeloma - surgery Orthopedics Pathological fracture Practice Guidelines as Topic Radiological Investigation Skeletal Metastases Surgeons Surgical management |
| title | The investigation and management of suspected malignant pathological fractures: A review for the general orthopaedic surgeon |
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